WHO Ⅱ级非典型脑膜瘤的临床特征与复发相关因素的研究进展

【摘要】非典型脑膜瘤(AM)是一种介于良性与恶性之间的侵袭性脑膜瘤类型，属WHO Ⅱ级。AM具有转移及复发风险，治疗主要以手术切除为主；其复发率接近25%～45%，通常在首次手术切除后2～4年复发，随着随访时间延长，复发率有上升趋势。至于接受大体全切除的AM患者术后进行辅助放疗仍存在争议，术后选择随访或进一步放疗的关键在于准确预测术后复发风险、充分评估放疗潜在益处和副作用之间的平衡。预测复发风险并采取个体化治疗方案是使AM术后患者获益最大化的重点。目前研究指出AM复发与手术切除程度、肿瘤大小、Ki-67指数、肿瘤部位、性别、术后放疗等因素有关，其预测价值及临床应用价值有待进一步研究。

Abstract： Atypical meningioma(AM) is an aggressive type of meningioma between benign and malignant, which belongs to WHO grade Ⅱ. AM has the risk of metastasis and recurrence, and the treatment is mainly surgical resection. The recurrence rate is 25% to 45%, and it usually recurs 2 to 4 years after the first surgical resection. With the extension of follow-up time, the recurrence rate tends to increase. As for patients with AM undergoing gross total resection, adjuvant radiotherapy is still controversial. The key to choosing follow-up or further radiotherapy after surgery is to accurately predict the risk of postoperative recurrence and fully evaluate the balance between the potential benefits and side effects of radiotherapy. Predicting the risk of recurrence and adopting an individualized treatment programs is the focus of maximizing the benefits of patients with AM after surgery. The current studies point out that AM recurrence is related to the extent of surgical resection, tumor size, Ki-67 index, tumor location, gender, postoperative radiotherapy and other factors. Its predictive value and clinical application value need to be further studied.